FOR CLINICIANS

Diagnosis-based guidelines for Medicare eligibility

HOSPICE REFERENCE GUIDELINES

NOTE:In situations of co-morbidities and/or rapid decline, patients may be hospice-appropriate even without meeting the diagnosis criteria listed below. The presence of two or more conditions within a given diagnosis warrants a hospice consultation.

NOTE:Bothcriteria 1 & 2 as well as either 3 or 4 must be present for hospice eligibility. However, certain cancer patients with poor prognoses may be hospice eligible without fulfilling any of these criteria.

Palliative Performance Scale 70%

Dependence in 2 or more ADLs

Pathology report indicates evidence of malignancy or metastases

Progression from earlier stage of disease to metastatic disease with either of the following: